Updated: Mar 1
By: Logan Cohen, Professional Therapist & Online Life Coach
Before I even considered a Master’s Degree at Lewis & Clark College in Family Therapy, I grew up in a Family with addiction and came by the disease of addiction myself honestly – so to speak. Yeah, I said it – DISEASE – not some indication that someone is fundamentally weak, or even lazy.
Do you remember the late and great comedian Mitch Hedburg who mesmerized the stand-up comedy community with his impeccable timing and stream of consciousness “one liners”? I was a teenager when he was hot on the scene and by that time, well into my own substance use issues. One of his jokes that made me “belly laugh” was as follows:
“You know what’s weird? Addiction is the only disease you can get yelled at for having. ‘Dammit Otto – you’re an alcoholic!’ – ‘Dammit Otto – you have Lupus!’ One of those just doesn’t sound right!”
I knew he was right and laughed hard as hell. I grew up in a Family with addiction and was already following in those footsteps. Even though my Mom drug me to Alanon and Alateen meetings as a Kid, those preventative measures were not enough to block me from my own inevitable introduction to mind-altering substances.
Mitch Hedburg died not too long after he broke out onto the stand-up comedy scene – found dead in his hotel room from an opioid overdose.
What is Addiction, you might ask? Well Addiction doesn’t care how smart or successful you are, or even how talented you might be.
Before I moved to Portland, Oregon for several years to complete a Master’s Degree at Lewis & Clark College, I lived and worked in the Appalachian Mountains alongside “at-risk youth” (adolescents coming out of youth detention centers and inpatient psychiatric placements) as their counselor and teacher.
This was a pivotal time in my Life that you can read more about here. However, for the sake of this article about the process of addiction treatment and recovery, this is when I got out of the booze induced stupor that was my undergraduate career at Athens, Georgia at the University of Georgia.
The town of Athens, Georgia is said by many to be, “a drinking town with a football problem”, and from what I remember, I followed suit. Needless to say, it did my budding – and then quite mature - alcoholism no favors. Those years living and working in the elements of Appalachia were also intended to help me dry myself out and do some much needed growing up – and they certainly did the job.
After three years of living in the woods with at-risk youth and working with those intense, albeit interesting young Fellas – I had to know more about the Family Systems that those kids were coming from.
I remember towards the end of my time in the woods, I began to see some younger siblings of Youth who had come through the program after their older Brother had passed through a few years back. I had just worked with the older brothers or cousins and my heart sank every time a familiar looking face would arrive, only to confirm in their charts a familiar last name.
At the end of the day, I am a protective older Brother and that was just not cool. It was time to study Family Systems Theory and figure out how to help People fix these bridges that are allowing generations of People to slip through the cracks.
While getting my Master’s Degree in Couples & Family Therapy at Lewis & Clark College, I chose to add a supplemental catalog of coursework to my degree so that by the time I graduated, I would also have completed the required coursework for becoming a Licensed Clinical Addiction Specialist. Through both personal experience and observation in clinical settings, I knew this was an area I would delve into and wanted to be sure that I knew what the hell I was doing.
The stakes are high and knowing a little bit about a lot of things might work well in some areas, but not in addiction treatment – that shit is just plain dangerous. In the end, I never completed the licensing process for getting the additional addiction specialist designation. I found that with my Couples & Family Therapy License alone, my private counseling group New Leaf Counseling Group in Charlotte, NC took off a lot faster than I was expecting.
Since the knowledge-base was already established, there was no need to secure an additional license and in fact, just seemed like another piece of bureaucratic documentation to keep up with and who needs that?? This all might change in the future, but needless to say I have continued to utilize this knowledge-base and skill-set in my clinical settings along the years.
I worked at a residential addition treatment facility for adolescents in Portland, Oregon - one of the original hot-beds of the opioid epidemic. I worked as a Family Therapist and for each patient that came into the treatment center for anywhere between 30-180 days, as I engaged the adolescents and their Family’s in Family Therapy. That was about as intense as you would imagine it could have been.
Addiction is a disease that is reinforced by loneliness and lack of healthy connection. If an adolescent becomes so addicted to a substance (or behavior) that they require residential placement for adequate treatment, then in 95% of those cases the Family dynamics are just plain JACKED up. My work was cut out for me as a Family Therapist and after having just spent a few years in a classroom setting after working in intensive wilderness settings for years, I was eager to get out there and engage again.
I had been sober myself for several years at that point as well but not so far removed that I had forgotten the throes of addiction – and those memories might never go away….
Anyways, I identified with those kids and those Kids knew that I understood their positions and didn’t judge their struggles. It worked and while it was intense and sometimes even SCARY – I LOVED IT!
So needless to say, I have got more than a bit of both personal and professional experience with addiction. I have grown up as a little boy in a household where I had no idea what was going to happen next and felt totally unsafe due to addiction in my Family, then eventually I discovered the “intoxicating” numbness of relief that would pour over me as I would pour alcohol into my body and it entered my bloodstream as an adolescent alcoholic, then I sobered up and now work with addiction frequently in clinical and therapeutic work.
So first - what is addiction? To put it plainly, addiction is a disease that the sufferer has a lot of control over. It is the same as in a case of diabetes. If the sufferer stays diligent in keeping up with their preventative treatment and makes responsible choices day in and day out, even when they are craving – they will stay healthy. As soon as they eat a cinnamon bun or chocolate sundae – if the disease is serious and/or progressed enough – they can get really sick, even risk full disease relapse and put their basic safety at risk.
So – what is addiction exactly, besides a disease that wreaks HAVOC on everything it touches?
There are a few different answers to that question because well, it’s complicated. If you are still reading this, then you can see how much first-hand experience I have had with addiction personally, as well as treating addiction in clinical and therapeutic settings. Over all of this time and experience, let me bring you in on the fundamental answers to the question, “What is addiction?”
#1 Answer to What is Addiction? Pleasure Gone Wild -
Addiction is a disease of inhibition loss towards satisfying dopamine centers:
When addiction is “in play” and someone is actively experiencing a “craving”, there is a literal loss of perceived inhibition by the person who has the addiction. It takes time, practice, and patience with potential ad real failure in order to learn how to control our behavioral impulses. This is why addiction is often hard to see as a disease for People. The disease itself attacks areas of the brain that guide our decision-making skills. We literally turn into stupid toddlers – no matter how smart or successful we are as Adults.
This also lends itself to explain why high-risk behaviors that result in big dopamine surges - such as gambling, sex, stealing, or even shopping and/or eating for some People - can become compulsive over time and feel like they are ruling – even ruining Our Lives.
I have spent thousands of hours in spaces of personal growth and development with men & boys as a mental health professional and designed a curriculum of online life coaching for men that is chalk-FULL of interventions designed to help you re-develop some of these essential aspects of your emotional and psychological development.
#2 Answer to What is Addiction? Addiction is the result of self-medication.
It was a band-aid that became its own issue. The original issue never healed.
You know the old saying about using drugs, sex, and rock n roll as a form of self-medication? Well, that one is true as the day is long. One essential area of Life that must be in play for Addiction to set in are the existence of external stressors – that’s called LIFE. Those stressors can be created by all kinds of variables that will be very different for every unique human being – from job loss in transitioning markets, to having kids, to losing Loved Ones – this can all be expected as a part of LIFE - but that DOESN'T make any of these experiences easy to deal with.
While these aspects of Life can be really tough, everyone has these in common and it is often easier to take other measures to deal with stress that seem more available - for whatever reason. like “lower hanging fruit.” Why wouldn’t we? It’s right there. However if this is relied on too frequently or heavily, then that substance use can turn into substance misuse and even an Addiction. This is how self-medication tends to be at the root of the issue.
Over time, I have found that it is more common for certain types of emotional health issues to go along with certain types of substances and/or high-risk behaviors.
For instance, People who are addicted to alcohol are very frequently dealing with underlying anxiety symptoms. Alcohol is such an effective short-term treatment for anxiety that it’s downright scary. In fact, I worked with hundreds of pediatric addiction cases with Adolescents & their Families at the rehab center as a Family Therapist and all of them had significant underlying anxiety issues. Whether these anxiety issues manifest as social anxiety, PTSD, panic attacks, or obsessive-compulsive tendencies - once we deal with those issues head on, the adolescent had a fighting chance to learn healthy ways to cope with daily life stressors in a way that keeps them “in the game” – so to speak.
#3 Answer to What is Addiction? Arrested Development
Addiction slows down psychological development – even freezing it until the addiction subsides
If you have asked ‘What is addiction?’, and have gotten a few good answers at this point…so let’s keep this party going!! Addiction puns? Too soon? Tough crowd…
Let’s continue with the thought above. Addiction is a disease that develops over time - sometimes taking repeated and prolonged exposures, while sometimes just one or two times. Addiction is also a disease that usually starts in adolescence between the ages of 11-22. Adolescents are inherently not yet fully-grown adults – even if they are Big or Beautiful - hence the whole separate category of this developmental stage.
Whenever the disease of Addiction sets in, the frontal lobe does not get a chance to fire normally – not as often, as strong, or for as prolonged periods of time (such as in extended problem solving through repeated failure while successfully practicing frustration tolerance).
As discussed in item #1 of this article, these are all features associated with the Frontal Lobe, which is a region of the brain that gets fairly muted by the disease of addiction itself. When this occurs a lot – as would be expected to be seen in a case of addiction – some important features of the frontal lobe do not get a chance to develop adequately. This frequently leaves someone who struggles with addiction a bit “behind he curve” when it comes to some important life skills - such as self-identity, confidence, impulse control, frustration tolerance, or the ability to have healthy interpersonal relationships - just to name a few
While it can be tiresome, even exhausting and de-moralizing to realize the extent to which we have “catching up to do”, even after we do the hard work to get sober, our ability to function across as many contexts of Life at a developmentally appropriate level is important for living a Healthy and Balanced Life.
This full range of fulfillment is what creates what People refer to as "Life Satisfaction."
But now we have to learn how to do all of that WITHOUT our [insert preferred brand of “drugs sex and rock n roll here”]? Yes, and that’s the “bad news” here.
Are you ready for the good news? Old dogs CAN learn new tricks. All of these life skills that can seem so intimidating are just skills. This is an area where your willingness to work hard and solve problems will come in handy. All of these skills might be different, but they can be learned - just like any other set of skills. These skills and more are covered at length throughout our Self-Guided Digital Plans available through The Balanced Man Plan.
#4 Answer to What is Addiction? Addiction is a Killer
Addiction (and other substance misuse) is the leading cause of death for young People
Whatever you are getting a bit carried away with – whether it’s alcohol, porn, gambling, pot, sex, or spending – they are not permanent solutions - and tend to create a bit of chaos themselves. Over time, high risk behaviors and chaos mixing together consistently over time results in death.
Whether the death is literally a direct result of drug use like respiratory failure from an opioid (or benzodiazepam) overdose, from seizures while going though alcohol withdrawal, or getting fatally injured while robbing a liquor store in order to go "score" (buy who knows what to get loaded) - substance use kills People. Whether directly and/or indirectly, substance use has a part in killing SO many men that the soaring high statistics for "deaths of despair" are probably even higher - after you account for secret using and "cover-ups" by wealthy institutions and Families.
Whether the cause of death was a direct result of substance misuse like overdose or not, you can only imagine how much violence, illness, death, and destruction, is left in the wake of addiction and substance misuse. This number cannot even be fathomed.
While this is horrible, it is not scary for most of us until we hear other statistics related to the impact of substance misuse. There is a sub-group of fatalities known as “deaths of despair” – composed of completed suicides and overdoses. This sub-group has been growing in numbers at such a staggering rate that the life expectancy of men has DROPPED in recent years…That is worth repeating so it can sink in…
Western Medicine has continued to advance at rapid rates and more is now possible than ever before to cure disease and help our community members live Happy & Healthy Lives longer – but NO – the life expectancy of men has actually FALLEN due to the sheer volume of “death of despair”.
Did you also notice that I am referring to “men” specifically here? This same trend has not occurred for women. The life expectancy of women has continued to climb as advancements in Science and Medicine have continued – as one would have expected…
This very reason is why I created The Balanced Man Plan. I had a tough time coping with emotional and learning issues as a young man and turned to high risk behavior as an adolescent - as MANY young men do when we don’t know how to make pain or anxiety stop. And as many young People do, I surrounded myself with Friends who were making similar choices.
As you might expect, 25 years ago is when I started using - ceasing problematic use about 10 years ago. However, statistically most People have trouble with stopping use of substances once the chronic disease of addiction sets in. Many of those childhood friends never stopped either. There are only a few ways for that story to END.
Many of those childhood friends are now dead. These “deaths of despair” have taken out too many old friends and acquaintances in their prime.
This is also why 20% of all proceeds will go to the National Suicide Prevention Helpline so that this nonprofit can continue to pay for staff and infrastructure required to provide 24/7 crisis support to callers with suicidal thoughts – when they finally reach out and call for help!
#5 Answer to What is Addiction? Addiction is a life-long battle.
Addiction is a chronic illness. It stays with you for LIFE. There is no "cure".
This means that technically once acquired, the disease doesn’t ever go away completely. You can absolutely get the symptoms under control, stabilize your Life, and “none would be the wiser” – but it isn’t considered healed – it’s just in remission. This makes a lot of People NERVOUS, but it is just a fact according to the National Institute On Drug Abuse. In my own personal experiences AND in my therapeutic work with clients recovering from Addiction, I have learned that it gets easier and easier over time to keep substance use under control with extended diligence, accountability, and success.
And as much as we might want a “one size fits all approach” to get relief from our symptoms, it just does not work that way. While there are many ways of doing things, over time I have learned that some styles of intervention work for just about everybody. At the same time, there are some very specific approaches that need to be taken with certain types of issues – remember - if we have been self-medicating for a long time and it has developed into an addiction, this means there is both an issue of compulsive behavior and an underlying issue as well.
It’s far from the “end of the world”, but it can be complicated and most interventions/approaches work a bit differently in each case. It is important to know that you have all of the information and support that is available for you to select from so that you can find the right combination for you.
The issue of addiction and it’s accompanying concerns can be worked through. You do not have to live your life “in” your addiction just because you happen to have one (and if you are willing to do the work – in remission to the degree that “none would be the wiser”)
#6 Answer to What is Addiction? A Family Disease
Addiction is a family disease – a disease requiring connection for full recovery
As discussed earlier in this article about working as a Family Therapist at a residential rehab center for adolescents, the issues surrounding addiction and compulsive behaviors can be understood as a “Family Disease” if you are willing to take a step back and take a look at the family context of when the problematic behavior began.
There is almost always an enormous external stressor that tends to be experienced during the time when problematic substance use sets in. The outcome of a perceived external stressor to that degree for an adolescent tends to result in their perception of social exclusion, even isolation – whether this is with their peers, family, or community at large.
This need of “Love & Belonging” is such a basic and fundamental need for Human Beings and especially during this phase of development – this results in a type of emotional and/or psychological “trauma”.
This trauma and the associated expectation for social exclusion or rejection gets woven into the problematic using behavior like “white on rice”. It is common that the social elements of someone’s problematic using behavior involves the re-creation of some of these aforementioned problematic interpersonal dynamics. Addiction is a chronic disease and if left untreated – it will progress over time. People can get so addicted that most of their behavior day-to-day is focused around creating access to, recovering from, or otherwise attempting to Balance out the consequences of their problematic using behavior.
The People who are closest to them risk becoming a part of these cycles that develop into the disease of addiction.
This is why social spaces of safety, sobriety, and growth such as 12 Step Groups like Alcoholics Anonymous and Al-Anon - even in addition to a free or paid plan with Balanced Man Plan can be so helpful in this day and age. Life moves quickly and it can be harder to find healthy connection these days more than ever, but we are doing what we can – when we can – where we can – to be part of the solution.
In addition to our forums and LIVE virtual groups with me directly, I designed the self-guided life coaching plans to address this specific area of concern at length in our “Balanced Friend Plan”, as well as woven interpersonal skill-sets strategically designed to overcome barriers related to social connection that men are most likely to face in day-to-day Life throughout each of the Self-Guided Coaching Plans available.
#7 Answer to What is Addiction? It Doesn’t Have To Be Like This
Addiction is treatable. It does not have to be miserable – or even about “getting by”.
While addiction and other types of compulsive high-risk behavior create a lot of misery and pain in this World, it doesn’t mean things can’t get better. In fact, Addiction is a treatable illness and there are many People who are in recovery from compulsive using and/or other high-risk behavior that live happy, even deeply fulfilling Lives.
The most popular way to seek relief from symptoms associated with substance misuse is with an “abstinence based approach.” This is completely appropriate for someone who was smoking crack, a hardcore alcoholic, or shooting ANYTHING into the vein. In case it needs to be said, NONE of the described activities are OK if you are interested in maintaining Balance with substance use.
Did he say, “Balance with substance use?” Yup –
Sometimes People choose to remain in compete abstinence from using after they have effectively stabilized for the rest of their Lives. And as mentioned above – in more severe cases of Addiction, this is the only option.
While there are many of these cases, there are a lot of times that People who struggle with substance misuse at even a moderate level can incorporate a degree of the substance use back into their Lives to some degree without becoming compulsive and destructive to themselves and those around them.
The name of this approach is called “Harm Reduction” and SAMHSA has given it’s support to intervention approaches of harm reduction for the effective management of substance misuse since the 1990s.
I personally and professionally support this approach and over time have found that “meeting People where they are at” in a sense of personal growth is the only way of going about things if you want to get things back into a real Balance – a sustainable Balance. Our Self-Guided Coaching Plans are designed with symptom relief in mind associated with the fall-out from Addiction. Remember all that talk about the importance of social connection and the acquisition of strategic skill-sets that can be learned – even as an “old dog”?
If you are getting your Life back under control after losing valuable time to addiction issues, we want to help you get things back into Balance. Or, if you are wondering whether you might have an addiction issue, or how to help a Loved One, we want to help you be part of the Solution for them TOO!
My name is Logan Cohen and I am a Professional Therapist & Life Coach with over 10 years in the field of Counseling Psychology. I am a Clinical Supervisor for the American Association of Marriage & Family Therapy, as well as the founder of New Leaf Counseling Group, LLC in Charlotte, NC. After spending tens of thousands of clinical hours with my own clients, starting a successful group practice, as well as a beautiful Family, I “picked my head up from the grindstone” to check in on childhood Friends & Loved Ones.
I painfully discovered that more than a few of my childhood Friends passed away at a young age from preventable health conditions and decided that as a Man, Husband, Father, and Friend, I could no longer stand by as People suffered in silence and self-destructed rather than ask for help. It doesn’t have to be like that and the holistic healing methods offered by the Balanced Man Plan is designed to help People “get unstuck” and break free from old patterns that are the barriers between Self & quality of Life.
The Balanced Man Plan is a therapeutic digital experience delivered through Self-Guided Coaching Plans created by a Male Therapist with the common barriers & strengths of Men in mind. The Balanced Man Plan has the goal of introducing a natural Balance back to Life so it is sustainable for the optimal Health & Well-Being of Self and Loved Ones - and ALL from the privacy and comfort of Home. If you have enjoyed what you see so far, check out our Self Guided Coaching Plans!